Do Sugar-Sweetened Beverages Cause Obesity and Diabetes? Industry and the Manufacture of Scientific Controversy

From University of California, San Francisco, and Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, California; University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies and School of Dentistry, San Francisco, California.

Jessica Tran, BA

From University of California, San Francisco, and Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, California; University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies and School of Dentistry, San Francisco, California.

Christina Mangurian, MD, MS

From University of California, San Francisco, and Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, California; University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies and School of Dentistry, San Francisco, California.

Cristin Kearns, DDS, MBA

From University of California, San Francisco, and Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, California; University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies and School of Dentistry, San Francisco, California.

From University of California, San Francisco, and Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, California; University of California, San Francisco, Philip R. Lee Institute for Health Policy Studies and School of Dentistry, San Francisco, California.

Grant Support: Dr. Schillinger was supported by grant 2P30DK092924-06. Ms. Tran was supported by grant 5T32DK007418-35. Dr. Mangurian was supported by grant K23MH093689. Dr. Kearns was supported by National Institute of Dental and Craniofacial Research grant DE-007306.

Editors' Note Regarding Disclosures (added 22 December 2016): The editors have become aware after publication of an activity relevant to the content of this article that was not included on the authors' disclosure forms. Drs. Schillinger and Kearns are affiliated with SugarScience.org. They report that they did not include this relationship with SugarScience.org on their conflict-of-interest disclosures because their contributions to SugarScience.org is part of their regular work duties at University of California San Francisco. For information about SugarScience.org, see www.SugarScience.org.

This article has been corrected. The original version (PDF) is appended to this article as a Supplement.

Background: The outcomes of recent regulatory initiatives, tax measures, and federal nutritional guidance designed to curb consumption of sugar-sweetened beverages (SSBs) have hinged on whether these beverages are a proven cause of obesity and diabetes. The SSB industry has opposed such initiatives, claiming that causation is scientifically controversial (1). We comprehensively surveyed the literature to determine whether experimental studies that found no association between SSBs and obesity- and diabetes-related outcomes (negative studies) are more likely than positive studies to have received financial support from this industry.